Unlike miscarriage and SIDS (Sudden Infant Death Syndrome), the tragedy of stillbirth remains largely uncovered by the media and unexplored by the medical community, even though it’s more common than you might think.
The Centers for Disease Control and Prevention, which defines stillbirth as the death of a fetus at 20 weeks of pregnancy or later, says that about 24,000 stillbirths occur every year in the U.S., making the stillbirth rate 10 times higher than the rate of SIDS, according to the Washington Post. What’s more, the World Health Organization ranks the U.S. stillbirth rate at 25th in the world, with three per 1,000 babies stillborn.
Also disappointing, the U.S. “has made some of the slowest progress of any country in reducing stillbirths,” writes reporter Sarah Muthler, whose own daughter was stillborn at 36 weeks. From 2000 to 2015, the U.S. rate declined by a mere 0.4 percent per year, putting us on par with undeveloped countries like Chad and Niger.
So why is the U.S. doing such a poor job of bringing down the number? There’s no national system to track stillbirths—a key step in preventing them—according to the CDC. Another problem: “The lack of insurance coverage for autopsies and genetic tests after a stillbirth,” writes Muthler. “If we don’t know more about why they happen, we won’t be able to prevent them.”
Although President Obama signed the Sudden Unexpected Death Data Enhancement and Awareness Act, calling for the federal government to continue collecting stillbirth data via the states in 2014, the law didn’t provide any additional funding for evaluation or research, which means that little has changed. (Except for reporting on death certificates, most states do little in the way of tracking stillbirths and their causes.)
Meanwhile in the Netherlands, a national program to evaluate stillbirths has helped the country reduce its stillbirth rate by an average of 6.8 percent per year between 2000 and 2015. Free autopsies and placental exams are offered following stillbirths, and experts review each case, hoping to identify problems in medical care and correct them.
In the U.S., the Stillbirth Collaborative Research Network has provided free stillbirth-related testing and counseling at a small number of hospitals. As a result, doctors were able to find “a probable or possible cause” in three-fourths of the stillbirth cases they looked at. “Doctors can’t say with certainty how many stillbirths could be prevented, but they know, for example, that a quarter of cases involve placenta problems, and if the placenta quits supplying nutrients to an otherwise normal baby, that baby likely could have been saved with an early delivery,” writes Muthler.
With adequate funding, researchers might eventually be able to develop screening tests to predict and prevent stillbirth, but until then the U.S. continues to lag behind, leaving mothers like Sarah Muthler to wonder what could have been done differently.